What is Retin A?

Tretinoin (retinoic acid) is a vitamin A derived cream that was developed 30 years ago. It was used initially for the treatment of acne. Now, however, several important derivatives of vitamin A are used by aesthetic doctor. These include isotretinoin and acitretin. It was found that these drugs affect cell differentiation. And, it can modify cell differentiation.This means that cells that have become undifferentiated or disorganised can be reorganised again.

Mechanism of the working of tretinoin cream

Tretinoin has some remarkable effects on the structure or restructuring of skin through the following route:

It can increases blood flow. This is by way of new blood vessel formation

Cell differentiation is improved. This means that the epidermis (top layer of skin) is rebuilt because the cells become uniform and well-ordered again. So, it can reorganized a disorganized skin upper structure. Consequently the epidermis thickens up once more to a young skin. It can anti age the skin, treat a skin disease.

Dermal re-structuring occurs with increased production of new collagen just beneath the epidermis. So, it can reorganized a disorganized skin deeper structure, the true skin layer, the dermis. The number of small fibrils that anchor the dermis (deep layer of skin) to the subcutaneous structure is doubled after only four months of treatment with tretinoin.

The number of pigment-producing cells is also reduced, with clearing of mottled skin discoloration. So, it is used widely as whitening agent for a snow-white and silky smooth skin. Eventually the uneven, dry patches disappear because of the gradual exfoliation of the surface resulting in smoother skin, the silky smooth skin.

Topical retinoids

Many proprietary brand-name creams containing retinoids, such as retinaldehyde, may be obtained over-the-counter, OTC, at pharmacies and supermarkets. There are used as a general home care cream. The effect is limited. The strength is usually 0.025% only.

However, only the more potent topical retinoids are very effective. There are only available by prescription. The strength is 0.05 and higher. These includes such as:

What are topical retinoids used for?

Scarring may be improved because of their ability to promote new collagen formation and so improve the appearance of hypertrophic scars.

Other skin diseases characterised by thick or scaly skin are also improved. This includes

keratosis pilaris,

acanthosis nigricans,

lichen planus and

granular parakeratosis.

What are the potential side effects of using topical retinoids?

Retin A Cream 0.1%:Given that this is the strongest strength, and mainly used for prescriptive formulation, it definitely causes many of the following side effects. Its effectiveness is very good.1. Skin Irritation–>Topical retinoids may irritate the skin particularly when first used. This may include skin peeling and stinging.-Excess use results in redness, swelling, peeling or blistering.-Topical retinoids may cause or aggravate eczema, particularly atopic dermatitis.-Irritation may also be aggravated by exposure to wind, cold, sunlight or use of soaps, cleansers, astringents, exfoliants and certain cosmetics.2. Photosensitivity: Topical retinoids may increase the chance of sunburn. It is important to wear sunscreen during the day and preferably apply the retinoid only at night.3. Pregnancy: Retinoids taken orally have caused birth deformities. It is recommended that topical retinoids are not used during pregnancy or whilst breastfeeding.

Given that this is the strongest strength, and mainly used for prescriptive formulation, it definitely cause many of the following side effects. Its effectiveness is very good.

Skin Irritation

Topical retinoids may irritate the skin particularly when first used. This may include skin peeling and stinging.